Episode Transcript
[00:00:01] Speaker A: This is the part, I think, that most of the other books about aging well are missing. They're all about supplements and taking different things. I think the most important thing you can do to age well is to change your mindset about aging if you have a negative belief about aging. So if you think aging is a time of decline and despair rather than a time of wisdom and opportunity and ability to give back to your community, you live seven and a half years shorter.
[00:00:41] Speaker B: Hi everyone, it's Jake Johnson. For this episode, we're thrilled to bring together in conversation two international experts on aging, co director of the Penn Memory center and executive producer of the age of Aging, Dr. Jason Karlewish and Chief Public Policy Officer for AARP, and author Deborah Whitman. Deb Wittman's new book, The Second 50 Answers to the 7 Big Questions of Midlife and beyond, tackles a topic that actually inspired the creation of this podcast, namely, that the world is getting older and how do we, the individual as well as the collective, prepare for or even think about a second 50 years of life? The book includes a lot of interesting insights, including dispelling a lot of common myths we have about aging, that adults over 50 actually are good for the economy, and that older adults are often happier than those in middle age.
I think you'll really enjoy this conversation between Deb Whitman and Dr. Karloish. They cover a lot of interesting topics in what It Means to Age well. And I ultimately walked away feeling more positively about aging, which Whitman said can actually help you live longer.
There's a lot to cover in this episode, and I'll catch up with Dr. Karlowitz at the end to reflect on the book and interview. But for now, let's dive right in.
[00:02:03] Speaker C: Well, Deb Wittman, it's such a pleasure to get together with you here to talk about your book, the second 50 answer to the seven big questions of Midlife and Beyond.
And I'm looking forward to diving in to a conversation about why you wrote it, how you arrived at the seven Big Questions, and then hone in on a couple of the questions. But before I do, I'd love to just get a chance for you to sort of describe who is Deb Whitman and what does Deb Whitman do on a typical day.
[00:02:29] Speaker A: Ooh, that sounds existential. But I'll tell you a little bit about my background and what I've been doing in my career.
So I've been working on aging issues since I graduated from graduate school with a PhD in economics. I started at the Social Security Administration doing research.
I worked on Capitol Hill for about a decade doing health care and then running the Senate Aging Committee, where I met a young Jason Karlowish on when I invited you to testify on why people in nursing homes should have the opportunity to vote. And then I've been at AARP for over a decade and here I lead our public policy work where we stand on every issue, our research. I have a public policy institute which are experts on everything from Social Security and Medicare and Medicaid to housing. I have a tiny brain health team that I'm sure we're going to talk a lot about their work. And I have a global thought leadership team. So we actually work to bring in good ideas from other countries and then also try to improve the lives of older people throughout the world.
[00:03:29] Speaker C: So it's fair to say that aging is very much on Deb Whitman's mind. And I deliberately said mind because I think the book opens with a very vivid account of aging, namely, not a story of policy or of data or of all the things that you thought about since your grad school days. The ways you've thought about aging, I should say, is what I mean, but rather a very personal story, beginning with your husband and his acute illness and how that experience caused you to reflect on a stark difference between the ways we approach acute illness and the successes we have there versus what's happening in the space of aging. Do you want to talk a little bit about that story?
[00:04:08] Speaker A: Yes, and I will try not to tear up.
[00:04:10] Speaker C: Yeah, it's a frightening tale.
[00:04:11] Speaker A: My 46 year old, really healthy husband is a multisport athlete in high school and in college. And my family had a vacation out in Colorado and we'd been out there for a couple of weeks and my daughter and I flew back and my, my son was doing an outward Bound. And so Glen stayed an extra few days to do some work. And on his last day before he picked up my son, he went for a hike just outside of Boulder in the mountains and started to feel some chest pain.
And the good thing is he's a teacher. And so he's had cpr, mandatory CPR training every single year. And he recognized this as something to be worried about. He did try to hike a little bit further, but then flagged down some hikers and they called 91 1. Luckily, Boulder Mountain Rescue, God bless them, raced at the mountain strapped into a gurney, raced him back down the mountain and got him to the emergency room where his heart stopped. There was a brilliant cardiologist right there on staff who got a couple stents in and in, you know, minutes, literally. He was out of risk. Some couple broken ribs from chest compressions. But he's alive and well today. And I share that story to open the book, because I want to be clear. I'm talking about the second 50, as if we're all going to have an extra 50. You don't know. Everybody's aging is different. You can be young and healthy and not even make it to your second 50.
And so I share a lot of information and insights in the book based on the experts that I talked to and researched on a set of fundamental questions that were important.
[00:05:56] Speaker C: But before we get there. So Glenn's doing okay now?
[00:05:59] Speaker A: Glenn's doing great. He just saw his cardiologist still not happy with his cholesterol level. But his. The test that you do where you have to run on a treadmill. The stress test. Yeah, stress test.
[00:06:09] Speaker C: But, you know, I think what your story animates is that, you know, once upon a time, but not too long ago, what happened to Glenn could have either have been lethal or extremely disabling. In other words, in the years to follow, heart failure and progressive decline such that, you know, would he even make it to 65?
[00:06:30] Speaker A: They call. They call that particular heart attack that he had a widowmaker, because the survival rate is almost.
[00:06:36] Speaker C: Yeah. Which gets it so much because, you know, women live longer than men, et cetera. But the point is, is. And I think what your book starts with is out of this vivid story, which I think many can relate to, because I was reflecting in my own childhood, a neighbor, Mr. Hopper, in the 1970s, grabbed his chest, went down, and by the late afternoon was dead.
And then Fast forward, about 15 years later, another neighbor had a similar event, but courtesy of all the advances in cardiovascular disease would go on to live for another 20 years. And I think what you're getting at as your opener in this book, told very vividly by your own personal experiences for as long as forever, until now, most of us didn't make it to 65, 75, let alone 80.
And yet now that's more the norm than the exception. Courtesy of great advances that have been made in public health, cardiovascular health, some other disease groups. And so we have to, as a society, confront the question of how am I going to live that second 50, quite literally, by you mean second 15. Many of us are going to make it to that ninth decade. We're going to make it to 100.
[00:07:34] Speaker A: You know, well, I have an uncle who just celebrated his 90th birthday, and I promised to write the third 50 if he makes it to 100.
[00:07:44] Speaker C: So you set out to sort of make sense of what amounts to almost a new phase in life for many people that we hadn't. For many. I'm of that age, I'll confess. You know, I'm 58. I grew up thinking getting to 65 would be a major accomplishment. And of course, you know, that now is at worst, I hope it's just going to be a bump in the road. So you looked into what's it take to live well in that second 50, and it's. It looks like you came up with about seven things that we need to sort of ask and answer, maybe just go through what sort of the seven big questions are without giving them the answers. But you distilled it down to seven things.
[00:08:17] Speaker A: So. So, like I said, I've been working on aging for my whole career. And then I was hitting my 50th birthday and realized there was a whole bunch that I didn't know or wanted to know better or knew abstractly like, women live longer than men, but I didn't know why. And so I wrote down a list of the questions that were important to me, and some of them are practical. The first one we've been talking about is, how long will I live? Will it be 50 or will it be 20? Will it be healthy? Very related. And then I asked the practical questions, like how long will I work? Will I have enough money? Where will I live? And then some tough questions. Will I lose my memory? How will I die? And so those became the chapters of the book. And for each, I interviewed smarter people than me, like you, and dug into the data and did a survey of the US Population and interviewed people across the country that were experiencing their second 50 in different ways and sort of wove that together so that people, you know, I had what to expect when you're expecting on my shelf. I didn't have what to expect when you're aging. And that's what I tried to pull together.
[00:09:23] Speaker C: So what to expect when you're expecting. Or it's the myriad of books that were written sometime beginning in the late 19th into the early 20th century about how to have a child and how to raise it. You know, in fact, you know, I remember my mother talking about the Spock book, you know, the book about how to raise your baby. And in some sense, I think what we're seeing now is a genre of literature. Very thoughtful. And I think your book is in the category of what I call the thoughtful books. There's a Lot of not so thoughtful ones about this second age, if you will, of how to live well in the face of, well, let's face it, you know, the last 50. So let's start. Let's dive in then. So the stereotype of the last 50 is it's pot marked with endless disease and disability, et cetera. What's your take on that?
[00:10:03] Speaker A: Our health and aging are related. As we age, our bodies change.
But I think the thing that I found out from the survey was people are actually happier. They're twice as happy in their 70s and 80s than they are in their 40s and 50s.
[00:10:20] Speaker C: Wait a minute, you've upended a stereotype right there. Because One stereotype is 70s and 80s, depression, anxiety.
And that's not the case.
[00:10:27] Speaker A: You know, all of us in our 40s and 50s that are trying to raise kids, maybe take care of our parents, the panini sandwich generation, however you want to define it, you know, and make a living, people are happier. And it's been shown in quite a few studies as we age.
And if you ask people, are you healthy in their 70s and 80s? They'll answer first the question, you know, do you have any chronic conditions or illnesses? Yes.
Are you healthy? Yes. And so I think it's a piece of our relative perspective that changes as we age. You know, we may not expect to have no aches and pains at 80 in the way I expect at 54. And being able to be as healthy as you can be in for that time, or healthier than somebody else, you know, who's worse off.
I think people accept a little bit more where they are than we realize when we're in our younger years and we're sort of looking forward.
The other thing that I think was really fascinating to me is there's so much that we can do to maintain our health as we age.
Probably the list of five healthy habits that will help you live a decade longer won't surprise anybody. You need to eat right. You need to exercise. You need to not smoke, not drink too much and maintain your body weight. So those five will get you about a decade longer. Even one gives you two years.
[00:11:55] Speaker C: Wow.
[00:11:57] Speaker A: But, you know, and this is the part I think that most of the other books about aging well are missing. They're all about supplements and taking different things. I think the most important thing you can do to age well is to change your mindset about aging.
[00:12:13] Speaker C: Why is that?
[00:12:14] Speaker A: If you have a negative belief about aging. So if you think aging is a time of decline and despair rather than a time of Wisdom and opportunity and ability to give back to your community. You live seven and a half years shorter. Dr. Becca Levy has done this incredible body of work showing how our mindset not only affects our lengths of life, but also even our risk for cardiovascular disease goes down if we have a positive view of age. They looked at the brain volume of people after they died and then looked back at what they said on surveys and whether they had a positive or negative view. And the brain volume was like three times higher for the people with a positive view on aging.
[00:12:56] Speaker C: So as you know, on the age of aging, one of our main sort of our theme is, you know, what does it take to age well with a healthy mind, you know, brain's important. Can't have a mind without a brain. But mind doesn't just come out of mind. Isn't just the brain spelled differently. It's a, it's a different. And so what you're getting at is, is when you say mindset is, what I hear you saying is there's the stereotype threat that we can create to ourselves a stigma that's a form of a stigma stereotype threat, which is adopting beliefs about aging, aging in general, that are going to actually make, they're going to fulfill themselves. You're going to fulfill the prophecy that you think of, I will age poorly. I will be unhealthy. I will, I will die sooner.
[00:13:38] Speaker A: Yeah. And you change your behaviors if you have a positive mindset.
[00:13:41] Speaker C: So let's get to behaviors because the five things that you listed, they're, they're fundamentally behaviors, their activities. And I do want to re highlight a point you said earlier, which was what you didn't say. I didn't hear a list of like the magic supplements. Like, it's all about fish oil.
Jason. Every time I drink green tea, I know that I, you know, I didn't hear a kind of list of a variety of. And I'm not going to name a product because neither you nor I want to get called dragged into court. But boy, you go online and find a whole host of things, you know, take them and drink them and whatever. And you know, that's the promise.
[00:14:18] Speaker A: But that's not my list and that's not where the real evidence is. And if we look even broader to health to be mindset is as, you know, it's personal behaviors and then it's our external society that influences as well. So things like air pollution affects our cognitive health and our physical health.
[00:14:39] Speaker C: You know, we're going to hit cognitive health in a minute because you know, we are age of aging. It's about mind and mind it is our focus. But I wanted to go to that list of five behaviors you made because what strikes me about all of them is how they're so interdependent to the environment that we live in, the world that surrounds us. And by world, I mean like the community we're in. I don't mean, you know, the world of the earth, although I think that has an impact to climate change being foremost there in terms of the world's impact on our health.
But I really came away from your book with there are things that we have to do as an individual, like habits I have to adopt. But all those five things are so wrapped up into the community I'm in and can I do them? And so let's talk about that. What was some of your takeaways? I remember especially at the end of, towards the end of the book, the Last bit better second 50, you started to look at some communities that have really made an effort to do that. So maybe let's talk about what does it take to have a, what is a community that's going to allow us to live well in that second 50, what do we need?
[00:15:42] Speaker A: Just start with how much diversity we have across communities in the United States.
So there's a 20 year life expectancy difference between the highest lived county, Summit County, Colorado, which is where Breckenridge is, and the lowest lived, Oglalakota county and South Dakota with a pine Ridge reservation, 20 years. People's biology are not that different across the country and, and even across states, West Virginia to Minnesota, people get diseases 20 years later in Minnesota than they did get them in in West Virginia. So, so we're seeing these huge disparities in health and longevity across the United States. And those aren't just that everybody does great things in one place and nobody does them in the other. As you say, it's sort of access to a healthy environment, access to healthy food, safe places to exercise.
Breckenridge's got a ski float right there. They're constantly at high altitude, which also helps their heart. All kinds of things are health supporting of their communities.
One of the big pushes that I've been working on in my day job is how do we make more and more communities age friendly? This is a model out of the World Health Organization which says to be age friendly we need to look at, you know, do you have a transportation system that works for people of all ages? Is your healthcare system inclusive? How about your housing?
[00:17:12] Speaker C: But so for Example, when you think about transportation, for example, what you're getting at there is how can we think beyond the culture of the car?
[00:17:20] Speaker A: We think about the culture of the car and even routes, you know, as we age, we need a route, you know, to the medical center with the doctors and maybe back to the hospital or to make sure it stops outside of the assisted living. So even just really thinking about the structure of your transportation system, building walkable communities is really crucial for people of all ages, bringing together people in ways they can be socially engaged. So that was another one of the real findings about what make us healthy as we age. I interviewed Bob Waldinger at Harvard, who done the Harvard study of Adult Development.
He looked at people in their 80s and said, okay, what's the difference between the healthy ones and the unhealthy ones?
And he looked back at their 50s and the real difference wasn't cholesterol, it wasn't exercise. It was who had better relationships with stronger relationships with, with family, with friends. People with stronger relationships in their 50s are much, much healthier than they're in their 80s.
And so, you know, these mindsets and relationships are what I'm selling, not dietary supplements.
[00:18:28] Speaker C: And yeah, you know, it's interesting, I, I was reading recently some Internet based publication about Brooklyn Museum having to lay off staff and otherwise. Really kind of like many cultural institutions struggling with making budget.
[00:18:42] Speaker A: Yeah.
[00:18:43] Speaker C: And one of the problems among several is, you know, they've never recovered, quote to the pre pandemic level of visitors, among some other matters. And it occurred to me there's these institutions out there, libraries, concert halls, museums, et cetera, that are somewhat struggling to repurpose themselves. Who goes to a library anymore? Some people laugh, which I think is a mistake, but they're an opportunity to address just this issue of socialization.
[00:19:08] Speaker A: Right.
I actually spoke at a mega church a couple days ago down in North Carolina. Really lovely community, 6,000 members. And I talked to them about even creating what's known as a village. These are really community based organizations, people in a neighborhood joining together to say, you know, hey, can we jointly share somebody who can shovel the walk? Not relevant in North Carolina, but. Or you know, come over and do handyman services and change light bulbs where we don't want older people standing on tall, unsteady things and falling and hurting themselves. Can we, you know, have the community arrange drives to the hospital or check ins, all kinds of things. And so, you know, there's, there's lots of ways that we can restructure both our policies at the federal level, but really even down to the local level, that can really make a difference in the environments that we create to be more healthy and more supportive.
[00:20:06] Speaker C: I think an approach to living well in the second 50 does require some national policies. I mean, there are some things at the national level we have to address. Right now we're facing some challenges there with respect to what are we going to do about, for example, Medicaid with proposals to cut up $800 billion, which is really going to challenge being able to live well in the second 50. But then there are some really, I think, clearly local things that have to be done to respect the particularities of the environment. People are around as you're raising in terms of transportation, accessibility, et cetera. And I think that was a key takeaway I put here. And you profile how California, for example, has made a effort as a state down then to the level of counties and cities to address this. It's a great bit to the end of the book, but let's pivot now to the brain, which is the question, will I lose my memory? Because isn't that pretty much guaranteed as we get older, we're going to lose our memory?
[00:20:53] Speaker A: No, it's not. As, you know, half of people surveyed feel that they're going to lose their memory as they age, but we know the rates are much lower than that. And Jason, actually, I would love your take. I had been saying only 17% or so people will develop dementia after 7:70. But I know there's a new Nature Medicine story out that is more inclusive of, like black women who have much higher rates.
[00:21:20] Speaker C: Yeah.
[00:21:21] Speaker A: What's the right rate that I should be saying?
[00:21:23] Speaker C: I think if that study is correct, I don't think we should debate the number to the digit, but it's saying between the ages of 55 to 95, the lifetime risk in that age span of developing dementia is 42%.
Much of that risk takes off after the age of 75. Yeah, and you're right, there's a big difference based on gender, race and certain genetics, which I think gets. I read it. I thought of your book because, yeah, there's genetics that does increase risk, but race, especially in American, this was an American data set, is deeply tied to where do you live, how were you treated, et cetera. It is highly wrapped up in social and economic factors, as is gender as well, to a degree. And that was one of the points that you saw on that site.
[00:22:08] Speaker A: And I got asked, why is it that black women have higher rates? And you know, if you think about an 80 year old black woman today, what she's had to face over the course of her life and racial segregation and access to healthcare and all kinds of things. But I, I didn't have a precise answer. Do you have a better one for.
[00:22:27] Speaker C: Me for the, for the precise risk of a, a person who self identifies as black, African American female? Yeah, yeah, I don't remember that from the study. The precise digit they gave you?
[00:22:37] Speaker A: Not the digit, but just understanding how do we explain why the racial and ethnic.
[00:22:41] Speaker C: Yeah, the study doesn't get a causation and mechanism the difference between women and men. Women are more likely than men to have dementia.
Much of it is explained by survival bias because the longer you live chronologically, the more likely you are to develop dementia. Having said that, I think the data surrounding events with menopause with women and its effect on brain health, that data is becoming more and more interesting, although I think it's still a work in progress.
So will I lose my memory? Not guaranteed. Where's the truth is it's somewhere between 17 and 42% is I think probably the answer, you know, the digit. But having said that, what do we, what, what were some of your key takeaways, some of your insights around what's it going to take to keep our brain healthy as we get older?
[00:23:22] Speaker A: Well, here again there's things that we as individuals can do and as society to reduce our risk factors for cognitive decline and dementia. And I think so many people think it's inevitable and that there's nothing that they can do. So just having a sense that again many of those healthy habits like eating right and exercising, having a healthy diet, using your brain, all are really important. We know even making sure that you get your hearing checked and where hearing aids can reduce our risk by about 40% and then some of the societal ones of, you know, how do we. We can reduce global risk by about 40% by addressing air pollution and education and a whole bunch of other things too.
[00:24:05] Speaker C: Yeah. The Lancet Commission's 14 modifiable risk factors life course beginning with education and ending later in life with hearing loss Correction explains about 41% of the of the population risk of dementia, which is interesting because the lifetime risk is 42% and you can reduce that by about 41%. It seems like the 40s are the key number still leaving 60% of risk, you know, unexplained and perhaps driven by biology or factors we haven't yet identified. Any other points on Will I lose my memory that you wanted to make?
[00:24:36] Speaker A: I told You, I interviewed people that I learned a lot from, you being one of them. In this, you and I talked about the importance of getting screened early, which I don't think I fully appreciated before I looked into this, of why, if there's nothing you can do about it, why would you want to know? And I think we had a good conversation about, you know, how can you put things in place to help you? You know, how.
[00:25:00] Speaker C: Yeah. Monitor and detect.
[00:25:01] Speaker A: How do you monitor, detect, create a support system around you, all of those things. I think we just did some work with mit hlab showing that in the years before diagnosis, people lose up to half their net worth in the six years before they're diagnosed.
And so the first sign of cognitive decline and dementia is numeracy, often, and inability to manage your money.
[00:25:26] Speaker C: Let's emphasize that point.
So you guys found that in the six years prior to a diagnosis of dementia, there's a substantial risk of notable losses to wealth.
[00:25:37] Speaker A: Huge.
[00:25:38] Speaker C: What's going on here isn't like healthcare spending. That's why it's.
[00:25:43] Speaker A: We're trying to get at all the pieces. It's not one. It's not one thing. So there was two studies. One credit ratings tank before you're diagnosed and your wealth drops by half in the six years before. And so some of the reasons that we are trying to tease out and understand a little bit more, some of it, you might lose your job. Right. So your income goes down.
Some of it is higher, susceptibility to fraud and financial exploitation. We had families that came in and told different stories. One, somebody who just started spending out of control in ways that they never did before. Others did have more expenses. So it was a range or as you know, it's really expensive to not pay your bills and have all the fees and other things. And so, yeah, a whole variety of things. But this connection between brain health and financial health was something we looked at last year that I, I don't think has been talked about enough.
[00:26:39] Speaker C: Yeah. And I mean, I, as you know, I'm a proponent of the concept of wealth care, which is, it's a clever play on the two words, W H, E, a, L, T, h care, namely the intersections of health and wealth. And you've yet again reiterated it. I want to give you the last words here. Your book began on a personal note. I want you to end on a personal note as you, you delve deep into the literature, interviewed the experts. What have you been doing for your own sort of living? Well, in the second 50, what are.
[00:27:07] Speaker A: Some of your Tips, you know, I am trying to exercise more. The part about relationships was something that now I'm sort of taking more active control over. Now that my kids have graduated and gone off to college, I have actually more time to see some friends occasionally and hang out with people in ways that, you know, maybe I suffered through with a big job and motherhood for quite a while.
[00:27:31] Speaker C: You say you're being more intentional about your relationship.
[00:27:33] Speaker A: I've been more intentional and purposeful. Purpose is also another thing that helps us as we age. I feel very purposeful in the work that I do and other things. And I'm also, you know, the book had me asking my family lots of questions and thinking about my own future. So I realized this house has six steps going up. And, you know, I. I had a.
My father in law's girlfriend over who looked at those six steps like they were Kilimanjaro. And I realized, you know what? I'm not going to be able to stay in this house. There's no way to modify those six stairs. And so, you know, understanding that at a certain point in my life, I will have to move. Having the conversations of each chapter with my parents, I learned.
[00:28:20] Speaker C: Can I interrupt you on that? I think that that statement that there'll come a point in my life where I'm going to have to move is incredible. I wish more people engaged in that process of. I'm going to use a strong word, discernment.
I find that the rhetoric of I'll never leave my house, you know, here till the end is both selfish and foolish. Selfish to the other people who may have to care for you and deal with the six steps. And foolish for the fact that, well, you do realize six steps could potentially be Kilimanjaro for you. And yet you're so wed to your, you know, really.
[00:28:53] Speaker A: Well, I'll. I'll say one. When I talk to my parents, their most important thing is they want to stay in that house.
[00:29:00] Speaker C: Yeah.
[00:29:00] Speaker A: That's their most important thing. And luckily, they don't have six. They only have a couple.
[00:29:05] Speaker C: Yeah.
[00:29:06] Speaker A: So they.
[00:29:06] Speaker C: Well, you know, if it can be retooled and modified, so be it.
[00:29:10] Speaker A: But they also live in a rural community in the middle of nowhere. And so, which gets my point.
[00:29:16] Speaker C: I think that we need to have a rethinking of what is this? What are we getting at when we say I'll never leave my home? And I have the hunch deep within that is this fear of could I ever create a feeling of home elsewhere? Knowing. And this gets Back to your policy issues that the places that we do create for older adults who are disabled can be pretty awful residential long term care settings. And I get therefore the sentiment of, quote, I'll never leave this home if you go see some of the places that are purported to be, quote, homes for people who are disabled and elderly. So I understand the sentiment. Yeah.
[00:29:48] Speaker A: And my parents live on a lake and they don't ever want to leave that view.
[00:29:52] Speaker C: No, I get it. Our house too is not age friendly. It's got stairs, there's no bathroom on the first floor. And as much as we adore our place, we know there'll come a time where we're going to have to probably, you know, move or put an elevator in. We'll see more intentional in relationships, more intentional in purpose in life. Taking a close look at the dwelling that you're in in terms of, you know, could I, could I be disabled and still reside here? So those are some very concrete things.
[00:30:19] Speaker A: And I'm getting on the exercise bike more regularly and doing Pilates to get some more muscles too. As we age, we need to do.
[00:30:25] Speaker C: Brilliant. Yeah. So not just in, not just cardiovascular, but some bulk and whatnot too. Absolutely. That's my prescription for my patients is just that both, you know, a little bit of bulk and also the cardiovascular system. Yeah, good for you.
[00:30:38] Speaker A: What's your list?
[00:30:39] Speaker C: Well, I, I have always been very, I've always enjoyed cultural events, music, dance, theater. But like you, you know, busy life, job, etc, I always had a reason not to go and not to go and then I've just become intentional about it, like buying the tickets and going to events. And in Philadelphia there's a big small arts community and so, you know, we've started to meet people, my husband and I, at various events. Oh, good to see you again. Et cetera. And it's, it's expanded a social network of like minded people in terms of interest in the arts. And one of the couples, we went to see the Ring cycle in Longborough and we're planning to go to La Scala in a year from now to go see the Ring cycle again. Do I do that because it's going to help my aging brain like taking cod liver of the Royal? No, but it just so happens. I think it's also helping me, but I enjoy it otherwise. But I don't think it's hurting me. And then like you exercise. I've always been an exerciser, just kind of a habit. But I decided to adopt the ultimate challenge. A few years ago I started taking Classes in Vergato. With ballet, I'm horrible, but I have gained pounds of muscle mass and flexibility.
And if ever there was one hour and a half where I think about nothing but what I'm doing and don't worry about my work, it's after an hour and a half of ballet class. So I'll stick with that until I fall.
[00:31:59] Speaker A: That's awesome.
I also started during the pandemic meditating, which is helping with stress.
[00:32:05] Speaker C: Deb Whitman. This has been a marvelous conversation. The book is the second 50 answer to the seven big questions of Midlife and beyond by Deborah Whitman. It is. As a writer, I'm going to say, by the way, you're a good writer.
Nice work.
[00:32:18] Speaker A: Thank you. I had help and I'm really proud of it because I tried to have a voice that everybody could read.
[00:32:23] Speaker C: Yeah. This is a very readable book. It's a very thoughtful book. It's full of insights. And the big takeaway I came from it was, yeah, there are things that we have to choose as our individual to do, but we have to work together as a. As a community and as a society to age well. This isn't just adopt good, healthy habits. It's about creating a healthy world environment to live well. So it's a brilliant book. And thank you so much, Deb, for taking the time to talk with me.
[00:32:49] Speaker A: Thanks, Jason. And thanks for letting me ask you questions, too.
[00:32:53] Speaker C: Not a problem.
[00:33:01] Speaker D: Well, I really liked that interview. I thought her perspective on aging was a very honest but pretty optimistic look at aging.
[00:33:11] Speaker C: Yeah, I agree. I agree. Yeah. And I enjoyed talking with her. It was a lot of. That conversation was a lot of fun. You know, she's. She's one of those unusual people who kind of occupy a host of different perspectives on aging and integrate them well, which I think is key. You know, she understands the science, she understands the medicine, she understands the public health and the policy. And that's what I think is unique and special about her as a person. And therefore, of course, the book that she wrote.
[00:33:39] Speaker D: Yeah. So I'm curious about your guys's relationship. Like, when did you first meet? And she said that you helped contribute to the research on this. And I'm wondering what that was like.
[00:33:50] Speaker C: Yeah. So we first met. This goes back to the events that surrounded the election of 2000.
And after that, in the aftermath, I think America had kind of a wake up call to voting rights for older adults because we discovered ballot design in Florida was pretty confusing for people in general. Anyway, I got for a number of years and Even still now I've been very interested in voting rights for older adults.
And one area that became an area of great interest was voting rights for older adults who live in residential long term care facilities or where their ability to get access to the vote is limited. And if they get access, particularly in the form of what we call, quote, an absentee ballot, you know that ballots in the control of the institution as much as the individual. Anyway, the point is that at that time Deb was on the Senate Committee on Aging as a staffer and they held a hearing on voting rights for older adults. It was a very productive hearing.
And I remember she reached out to me, I didn't know her at the time and I testified and I remember I met Senator Casey and that resulted in some substantive recommendations and that works had a lot of impact. Anyway, she went on to the AARP and, and I re met her again a number of times given my work on the Global Council on Brain Health, which AARP organizes.
And then as she wrote the book, actually you're right, she did interview me. I'm, I'm in the book particularly chapter around cognitive health. How will my, my memory change as I age. And we talked a lot about, and it came up at the end of the interview as well, you know, the, the role of creating a trusted network of support both for monitoring detection and then as problems are detected, to step in and care. And that was a lot of our conversation.
[00:35:26] Speaker A: I remember.
[00:35:27] Speaker D: Well, that's so funny that you guys met over voting rights because we, we had an episode last season all about voting rights and dementia.
[00:35:36] Speaker C: Came right into those kind that work.
[00:35:37] Speaker D: Yeah, yeah. That's amazing. So one of the biggest takeaways from me and kind of one of her theses it seems from her book is she lays out these ways to age well and she says they won't surprise anybody. And she says eat right, exercise, don't smoke, don't drink too much, maintain a healthy body weight. And then her kind of addition to it is to change your mindset about aging.
Could gain seven years, I think she said, of life by having a more positive outlook about aging. What do you think about that? I'm curious.
[00:36:16] Speaker C: All of those wrecks are, I think are solid, I know, are solid and well established recommendations. You know, what eat right is getting at is, you know, cardiovascularly healthy diet, for example.
And you know, what's reassuring is the data that supports each of those recommendations is backed up by solid evidence. Much of it from epidemiology and related studies, some of it from, from Controlled trials and such. The, the positive outlook is I think, one that I think surprises many people. And I think some people wonder, is that cause or is that effect?
There's always a hard thing to tease out. In other words, do I have a positive outlook because I'm aging well or because I have a positive outlook I'm aging well? Or perhaps it's a little bit of both.
But I mean it, it reminds me of data that's out there that people who have chronic stress, and if you look at what, what those measures are, they're measures of what used to be called neuroticism, sort of the chronic worriers tend to be people who are more likely over time to develop dementia.
Again, cause or effect or a little bit of both to be worked out. But there's something to be said that individuals who live a life that is free of stress, worry, anxiety, tend to do better over time. Some of it may have to do with social networks, for example. You know, they're, they're more likely to be sociable, have activities that are meaningful, that engage them, et cetera. I think fundamentally, I hope no one's disturbed by that finding. I think it's actually something good to. There's something to be said for well being and, and you know, having a perspective on life that has some degree of, dare I say, hope.
[00:37:43] Speaker D: Yeah, yeah.
[00:37:45] Speaker C: Having said that. So all those things that you listed out are of course, things that an individual does. They choose to exercise, they choose to. But you know, I think the other key theme in her book is much of that is a function of where you live, you know, who's around you, what resources do you have access to? Are you in an environment where, you know, it's possible to get out and engage in exercise, where it's possible to socialize and meet other people and so on. And I mean, she points out there's vast disparities in life expectancy, a crude measure of aging well, but nonetheless a useful one. And as she points out, that can't simply be biology.
It likely has something to do with those places and what makes those places different in terms of the ability to age well versus to age not so well.
[00:38:31] Speaker D: So yeah, I haven't, I haven't read the book. I know that you have. So she gets into a lot of these more kind of socio, economic, broader structural things that we need to change.
[00:38:43] Speaker C: Exactly, exactly. She points out very concretely certain states, counties that have really taken on the challenge of what will it mean to create a healthy space for us to live in and, you know, I think the current political time we're in actually has woken up to the problem of chronic disease and the need to tackle chronic disease.
And I think that's great. Could it be the topic that finally brings together long standing rifts in our politics that seem to sort of say, you know, there's something wrong when we sort of create healthy communities because the state is interfering in the community, or other kind of sort of odd libertarian ideals. And I don't think they're actually very libertarian, they're just kind of quirky. You know, the moment the government steps in to make sidewalks, that's an intrusion, you know. You know, I. I think the public space is. It's just that it's a space that the public, the government, communities. I say government. I'm meeting local governments particular because they know their community ought to come together to create a more healthy environment, you know, for individuals. You know, I live in Philadelphia, you live in Philadelphia. And you know, I'm eternally grateful for the wonderful bike lanes that we have in the city that really allow me to get around and not take a car or a bus. And I see a lot of other people on those bikes and a lot of them take those bikes that are like hooked up in the, you know, the rental things as well. You know, it's those kind of initiatives that you need that a community needs to take.
[00:40:05] Speaker D: Yeah, yeah. We just had our thank you lunch for the participants in the studies at the Memory center. And I was going around during the lunch talking to some of the participants, and I was talking to one woman who lives like three blocks away from me, and she was just like, I've lived in my apartment for this many decades, and I have the hardware store down the street and I have the park the other direction, and I have the supermarket this way. And like, I was just reflecting on how nice it is to live in a place that is so walkable. I mean, we've talked about it before, but I could imagine as an older adult having things close by and accessible like that. That has to do something for your aging and longevity.
[00:40:50] Speaker C: Absolutely, absolutely. You know, I've been reflecting a lot on the concept of the automobile. And it's not so much the automobile as the object, it's the automobile as the concept.
Meaning, you know, not just the four wheels with an engine or however many wheels, but the idea that we want to be able to get out and get to places that we enjoy going to, that we need to go to, that give us meaning.
And for much of the 20th century, especially in America, that was determined by the automobile as a fuel powered, sometimes quite large device that needed to be kept in its own little room and all these other things. And if you think about the idea of the automobile as an idea, not just the object, you don't necessarily need the object. You need the ability to get to places because they're close, perhaps. And this is where like E bikes are tremendously interesting. And I was chatting with someone I know who's older and he was just praising his E bike because it lets him get out and around with a minimal amount of exertion. And yet there is some exertion and travel a distance otherwise would have been prohibited on his bike just in terms of the amount of time and physical effort given exhaustion. And now he can get out and it's not with a car, you know. So I think E bikes and related kind of E scooters and whatnot are another example of they're like the automobile. They're not automobiles as we understand it, but they're the concept of that device that lets me get out and around. And E bikes for older adults have been actually quite beneficial because of the, you know, the challenge of pumping a bike up a hill is not. Is a challenge for many people.
[00:42:24] Speaker D: Another concept or another moment from this episode that I was, I really enjoyed was you both were coming from the perspective of when you were growing up, the idea of having a second 50 was not something that people commonly held. And you cited a neighbor that died of a heart attack and the idea of making it to 65 being a big accomplishment. And that was kind of one of the reasons for starting this podcast and naming it the age of Aging. Is this growing older population people living a lot longer? And I'm curious what your perspective is about the impact that this will have. I know this is a broad question, but the impact that this will have on. On us.
[00:43:09] Speaker C: Yeah, well, the fact is we are living longer, period, some than others. One of the real challenges with living longer is that behind lifespan is health span, how to maintain being healthy. Well, being physical and mental in those added years.
I think that's one of the great challenges tied into that is wealth span, having enough wealth to make it to those last few years. And I think this is the challenge in the 21st century, which is I'm going to live longer. Will I be healthy in those last years and will I have enough wealth to live well in those last years?
And this is a challenge which is a top down challenge to countries because it's not just about medical care. We've been talking about a lot about non medical issues, but it's also about wealth, having enough money to make it that far.
And you know, that's why I was at a recent conference that the Pension Research Council led by Olivia Mitchell here at Penn sponsored. And I was thrilled that in the room were, you know, investment managers, wealth managers and gerontologists and related scientists and even me, the doctor, giving a talk. Because I think that it's that kind of meeting of the minds that has to occur to address what frankly is a challenge that has never been experienced in the history of humankind. There's no century where we've enjoyed this expansion in longevity and therefore the intended challenges that it presents.
[00:44:37] Speaker D: So every week we've been asking a beautiful question to the audience. Call in and give their responses.
So last week's question was what is something you are proud of in your life?
And we got a lot of great responses from that, including a call in from my co host Terrence Casey's kids.
[00:44:57] Speaker E: Hi dad, this is Dottie Bridget.
Something I'm proud of is hitting a big double in my baseball game and getting the game ball.
Something I'm proud of is doing dance in my dance recital.
Something I'm proud of with my brother because he had the rain ball.
[00:45:17] Speaker C: Bye.
[00:45:20] Speaker E: Hi, my name is Deirdre Collins.
I'm calling from Abington and this is going to be a boring one, I guess. But I am most proud of my children. How they are such beautiful people, how hard they work, how they love their families and how they try to do good in the world. And also, although I can't take any credit for it, I'm proud of their spouses, my son in laws and my daughter in law similarly because they also work very hard, love their families and try to give something back to the world. And though it seems boring at the age of 67, having been a doctor, still being a doctor and done many, many things, by far, this is the most wonderful thing I've ever done.
[00:46:10] Speaker D: This week's question is what is something that makes you laugh?
[00:46:15] Speaker C: Well, you know, I mean the obvious, you know, like comedy obviously, but that's like saying, you know, what makes you cold? The winter.
But you know, I, I always, I will say a couple things. One thing that makes me laugh or at least smile consistently. Are rabbits okay? I mean there's nothing, bunny rabbits just how can you not at least smile when you see a bunny rabbit, right? It's just like what is it that when, when those creatures became Created, you know. But I will say the other thing that definitely makes me always at least smile and laugh is my dog, Moby. He's just the endlessly friendliest, cutest, liveliest little fellow, and you can't not. But at least smile as not laugh when you're kind of around.
[00:46:54] Speaker D: Moby, you stole my answer. That was going to be my. That was going to be my answer. Was my dog really?
[00:46:59] Speaker C: Well, there it is. Well, there's something to be said for that.
[00:47:02] Speaker D: Something about animals when I was thinking about this the other day, when they do something that they're not supposed to do, like my dog, whenever I'm. Whenever I'm getting ready to take her on a walk, and she just starts going absolutely crazy and jumping and pushing me with her paws, and it's so bad, and I know I can't. I shouldn't be letting her do it, but it always makes me laugh.
[00:47:22] Speaker C: And I'm like, yeah, my dog adores sticks. So there's sticks everywhere. He totally ignores them. But the moment you pick up a stick, he just becomes, you've got to throw that stick.
You wait, you know, it's like there's.
[00:47:35] Speaker D: Sticks everywhere, but that.
[00:47:37] Speaker C: Pick it up and it's like, I want to give it. Yeah, exactly. So here we are, smiling and laughing.
[00:47:42] Speaker D: Exactly.
[00:47:43] Speaker C: Yeah. Just thinking we ought to do an episode on. On. On pets, especially dogs.
[00:47:47] Speaker D: Yeah. Next season. I think that that would be a great episode.
[00:47:51] Speaker C: Let's put it on the chalkboard.
[00:47:52] Speaker D: Philly's a big dog city. I've noticed. So, you know, there'll be plenty of people to talk to. All right, well, thank you, Jason. Really appreciate you coming.
[00:47:59] Speaker C: Thank you, Jake. It's always great. It was a lot of fun talking to Deb and look forward to the next author. I've got a couple of ideas in mind, but if there are any authors out there who would like to talk, give me a holler.
[00:48:08] Speaker D: Oh, and before we go, I want to mention the phone number to call in is 571-4-49-6474. So that's 571-4-4490, 6474. We'll have that in our show notes as well.
Please call in. We love getting your calls. We love putting them in the episode, and we love hearing from you. So what makes you laugh. You can also say your dog if you want.
[00:48:32] Speaker C: So.
[00:48:33] Speaker D: All right. Thanks, Jason.
[00:48:35] Speaker C: Thanks, Jake.
[00:48:40] Speaker D: Thanks for listening to this episode of.
[00:48:41] Speaker B: The Age of Aging.
[00:48:43] Speaker D: The Age of Aging podcast is supported by the Penn Memory center, the University of Pennsylvania Alzheimer's Disease Research center, the Institute on Aging and the Penn FTD Center.
[00:48:53] Speaker C: Contributors include myself and Jake Johnson, as well as Nicolette Calcavecchia, Dahlia Elsai, Jason Karlewish, Emily Largent and Megan Sharp.
[00:49:04] Speaker D: More information on the stories you heard today can be found in our show Notes and on our website, penmemorycenter.
[00:49:10] Speaker C: Org.
